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DEPARTMENT OF DEFENSE APPROPRIATIONS

FOR 1993

HEARINGS

BEFORE A

SUBCOMMITTEE OF THE

COMMITTEE ON APPROPRIATIONS
HOUSE OF REPRESENTATIVES

ONE HUNDRED SECOND CONGRESS

SECOND SESSION

SUBCOMMITTEE ON THE DEPARTMENT OF DEFENSE

JOHN P. MURTHA, Pennsylvania, Chairman
NORMAN D. DICKS, Washington

JOSEPH M. McDADE, Pennsylvania
CHARLES WILSON, Texas

C. W. BILL YOUNG, Florida
W. G. (BILL) HEFNER, North Carolina CLARENCE E. MILLER, Ohio
LES AUCOIN, Oregon

BOB LIVINGSTON, Louisiana
MARTIN OLAV SABO, Minnesota

JERRY LEWIS, California
JULIAN C. DIXON, California
BERNARD J. DWYER, New Jersey
DONALD E. RICHBOURG, J. David WILLSON, JOHN G. PLASHAL, ROBERT V. DAVIS, SANDRA A. GIL-

BERT, David F. KILIAN, DELACROIX Davis III, ALICIA JONES, JULIE PACQUING, TIMOTHY L. PE-
TERSON, GREGORY J. WALTERS, DAVID W. ROBERTS, and MARCIA L. Matts, Staff Assistants;
CINDY E. WAGNER, Administrative Aide

PART 2

Medical Programs......
Drug Interdiction and Counter-Drug Activities, Defense.......
Environmental Restoration, Defense .....
Testimony of Members of Congress and Other Interested

Individuals and Organizations .

Page

1
267
385

457

Printed for the use of the Committee on Appropriations

U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON : 1992

59-855 0

For sale by the U.S. Government Printing Office
Superintendent of Documents, Congressional Sales Office, Washington, DC 20402

ISBN 0-16-039798-7

• A6
1949

COMMITTEE ON APPROPRIATIONS

JAMIE L. WHITTEN, Mississippi, Chairman WILLIAM H. NATCHER, Kentucky,

JOSEPH M. McDADE, Pennsylvania Vice Chairman

JOHN T. MYERS, Indiana NEAL SMITH, Iowa

CLARENCE E. MILLER, Ohio SIDNEY R. YATES, Ilinois

LAWRENCE COUGHLIN, Pennsylvania DAVID R. OBEY, Wisconsin

C. W. BILL YOUNG, Florida EDWARD R. ROYBAL, California

RALPH REGULA, Ohio LOUIS STOKES, Ohio

CARL D. PURSELL, Michigan TOM BEVILL, Alabama

MICKEY EDWARDS, Oklahoma BILL ALEXANDER, Arkansas

BOB LIVINGSTON, Louisiana JOHN P. MURTHA, Pennsylvania

BILL GREEN, New York BOB TRAXLER, Michigan

JERRY LEWIS, California JOSEPH D. EARLY, Massachusetts

JOHN EDWARD PORTER, Mlinois CHARLES WILSON, Texas

HAROLD ROGERS, Kentucky NORMAN D. DICKS, Washington

JOE SKEEN, New Mexico MATTHEW F. McHUGH, New York

FRANK R. WOLF, Virginia WILLIAM LEHMAN, Florida

BILL LOWERY, California MARTIN OLAV SABO, Minnesota

VIN WEBER, Minnesota JULIAN C. DIXON, California

TOM DELAY, Texas
VIC FAZIO, California

JIM KOLBE, Arizona
W. G. (BILL) HEFNER, North Carolina DEAN A. GALLO, New Jersey
LES AUCOIN, Oregon

BARBARA F. VUCANOVICH, Nevada
BERNARD J. DWYER, New Jersey

JIM LIGHTFOOT, lowa
STENY H. HOYER, Maryland
BOB CARR, Michigan
ROBERT J. MRAZEK, New York
RICHARD J. DURBIN, Mlinois
RONALD D. COLEMAN, Texas
ALAN B. MOLLOHAN, West Virginia
LINDSAY THOMAS, Georgia
CHESTER G. ATKINS, Massachusetts
JIM CHAPMAN, Texas
MARCY KAPTUR, Ohio
LAWRENCE J. SMITH, Florida
DAVID E. SKAGGS, Colorado
DAVID E. PRICE, North Carolina
NANCY PELOSI, California
PETER J. VISCLOSKY, Indiana

FREDERICK G. MOHRMAN, Clerk and Staff Director
NOTES:

The Honorable Silvio 0. Conte was Ranking Minority Member of the Committee until his death on February 8, 1991.

The Honorable William H. Gray III resigned from the Committee on September 11, 1991.

DEPARTMENT OF DEFENSE APPROPRIATIONS

FOR 1993

THURSDAY, MARCH 12, 1992.

MEDICAL PROGRAMSDEPARTMENT OF DEFENSE

WITNESSES
HON. ENRIQUE MENDEZ, JR., ASSISTANT SECRETARY OF DEFENSE FOR

HEALTH AFFAIRS, DEPARTMENT OF DEFENSE
LT. GEN. FRANK F. LEDFORD, JR., SURGEON GENERAL, U.S. ARMY
VICE ADM. DONALD F. HAGEN, SURGEON GENERAL, U.S. NAVY
LT. GEN. ALEXANDER M. SLOAN, SURGEON GENERAL, U.S. AIR FORCE

INTRODUCTION
Mr. MURTHA. The Committee will come to order.

We want to welcome Dr. Enrique Mendez, the Assistant Secretary of Defense for Health Affairs, and the three Services' Surgeons General. I know we always have an interesting hearing, but this morning at our public witness medical hearing, a number of problems came up in talking about the CHAMPUS Reform program that was instituted in California as a demonstration project by the Department, which we feel has worked very successfully.

We are looking forward to your testimony, and then getting to questions. So we will put your full testimony in the record and if you would summarize your remarks, we will get right to the questions.

SUMMARY STATEMENT OF DR. MENDEZ Dr. MENDEZ. Mr. Chairman, distinguished Members of the Committee, I am pleased to be here this afternoon, and I thank you for the substantial support and thoughtful guidance your Committee has provided over the years. I want to thank you also for the opportunity to discuss with you the programs and initiatives under way within the Military Health Services System.

Mr. Chairman, I will proceed with a summary of my testimony.

Our efforts this year span all avenues of health care pursuit: management, structure, organization, budget, delivery, quality, and systems. In each endeavor, this Committee has maintained active

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